4. 4
Cardiovascular System
• Transports O2 and fuel to the cells, tissues,
and organs.
• Removes CO2 and wastes from the cells for
elimination from the body.
• Must be able to maintain sufficient flow
through the capillary beds to meet the cell’s
O2 and fuel needs
7. 7
Internal Bleeding S/S
Think about MOI or NOI!
Anxiety, restlessness, irritability
Pale, diaphoretic skin
Sustained tachycardia
Hypotension
Unstable vitals signs (postural changes)
8. 8
Internal Bleeding S/S
Vomiting bright red blood or coffee ground
material
Bleeding form any body orifice
Dark, tarry stools (melena)
Tender, rigid, or distended abdomen
Pain, discoloration, swelling, tenderness at
injury site
9. 9
Managing Internal Bleeding
ABC’s
High concentration oxygen
Assist ventilations
Control external bleeding
Stabilize fractures
RICE
Transport rapidly to appropriate facility
15. 15
Tourniquets
Final resort when all else fails
Used for amputations
3-4” wide (blood pressure cuffs)
Write “TK” and time of application on
forehead of patient
Notify other personnel
Once applied, DO NOT REMOVE
16. 16
Epistaxis (Nosebleed)
• Causes
– Fractured skull
– Facial injuries
– Sinusitis, other
URIs
– High BP
– Clotting disorders
– Digital insertion
(nose picking)
17. 17
Management of Epistaxis
Sit up, lean forward
Pinch nostrils together
Keep in sitting position
Keep quiet
Apply ice over nose (15 min)
Can result in life-threatening blood loss!
19. 19
Physiology
• Cell is the basic unit of life
• Cells get energy needed to stay alive by
reacting oxygen with fuel (usually glucose)
• No oxygen, no energy
• No energy, no life
27. 27
Psychogenic Shock
• Simple fainting (syncope)
• Caused by stress, fright, pain
• Heart rate slows, vessels dilate
• Brain becomes hypo-perfused
• Loss of consciousness occurs
• Patient usually recovers by self
28. 28
Psychogenic Shock S/S
• Anxiety, restlessness, irritability
• Rapid pulse
• Normal or low blood pressure
• Hyperventialtion
29. 29
Hypovolemic Shock
• Loss of volume
• Causes:
– Blood loss from trauma
– Plasma loss from burns
– Fluid/electrolyte loss from vomiting,
diarrhea, sweating, increased urine
output, increase respiratory loss
– “Third space” fluid shifts
33. 33
Distributive Shock:
Anaphylactic
• Results from severe allergic reactions
• Body responds to allergen by releasing
histamine
• Histamine release causes vessels to dilates
and become “leaky
37. 37
Cardiogenic Shock
• Pump failure
• Heart’s output depends on
– How often it beats (heart rate)
– How hard it beats (contractility)
• Rate or contractility problems cause pump
failure
38. 38
Cardiogenic Shock S/S
• Causes
– Acute myocardial infarction
– Very low heart rates (bradycardias)
– Very high heart rates (tachycardias)
Why would a high heart rate caused decreased output?
Hint: Think about when the heart fills.
40. 40
Respiratory Shock
• Failure of respiratory system to supply
oxygen to or remove CO2 from the alveoli
• Airway obstruction
• Flail chest, SCW
• Pneumothorax
• Respiratory muscle paralysis
42. 42
Neurogenic Shock
• Spinal cord injuries that result in the
interruption of communication
pathways between CNS and rest of
body
• Vessels below the injury site dilate
leading to decreased vascular
resistance
44. 44
Treatment
• ABC’s
• Apply O2, assist ventilations as needed
• Keep patient in position of comfort
• Control bleeding, stabilize fractures
• Prevent loss of body heat
• Assist with medications
• Nothing by mouth
• Calm and reassure
45. 45
Treatment
• Elevate lower extremities 8 to 12 inches in
hypovolemic shock
• Do NOT elevate the lower extremities in
cardiogenic shock
Why the difference in
management?
46. 46
Shock is NOT the same as low
pressure
A falling blood pressure is a
LATE sign of shock!
